At the recent Washington Square Health Foundation’s (WSHF) annual meeting, we spent a board development session discussing the current health care environment in the Chicago area. For the last several years, WSHF has focused grant making activity on funding “gaps” in the Affordable Care Act of 2010. Examples include mental health services, dental services (especially pediatric dentistry), primary care access for homeless or undocumented people who otherwise get their care in the emergency room, and medical education and medical research.
Agencies such as Lutheran Social Services and Catholic Charities have helped to fill these gaps. Given the state budget impasse in Springfield, the agencies are not receiving funding and are forced to layoff massive numbers of staff and drastically cut services. In addition, several city supported mental health clinics in Chicago have been closed due to funding priorities.
As reduced staffs struggle to provide basic health care services, patients are either forced to wait or seek care in emergencies rooms – the most expensive and inefficient care setting. Howard Nochumson, Executive Director, commented that providers and agencies are being forced to “make bricks without straw.” This was in reference to the Bible story in Exodus 5 of the Israelites who were held captive in Egypt. When Moses and Aaron, their spiritual leaders, asked for three days to worship their God, the Pharaoh responded that the Israelites were lazy and as punishment were now to make bricks without the essential ingredient of straw for drying and hardening. Nevertheless, they would be expected to continue to make the same daily number of bricks for the Pharaoh’s building programs.
Mr. Nochumson’s insightful comment captures the plight of Chicago area health care providers trying to maintain service levels with reduced staff and resources. The harsh reality is that non-governmental charitable organizations are not able to fill the funding gaps created by the political dysfunction in Chicago and Springfield. There is only so much “straw” to go around from private philanthropy.
William N. Werner, MD, MPH, FACP